Provider Demographics
NPI:1043307358
Name:CALDWELL, ALEXANDER SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:SCOTT
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2210
Mailing Address - Country:US
Mailing Address - Phone:559-686-4897
Mailing Address - Fax:
Practice Address - Street 1:1255 N CHERRY ST PMB 611
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2233
Practice Address - Country:US
Practice Address - Phone:559-686-4897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G324240Medicaid
CA00G324240Medicare ID - Type Unspecified
CA00G324240Medicaid